Associations between fibrin D-dimer, markers of inflammation, incident self-reported mobility limitation, and all-cause mortality in older men

Wannamethee, S. G., Whincup, P. H., Lennon, L., Papacosta, O. and Lowe, G. D. (2014) Associations between fibrin D-dimer, markers of inflammation, incident self-reported mobility limitation, and all-cause mortality in older men. Journal of the American Geriatrics Society, 62(12), pp. 2357-2362. (doi: 10.1111/jgs.13133)

Abstract

Objectives<p></p> To examine the independent relationships between fibrin D-dimer, interleukin 6 (IL-6), C-reactive protein (CRP), and fibrinogen and incident mobility limitation and mortality.<p></p> Design<p></p> Prospective.<p></p> Setting<p></p> General practice in 24 British towns.<p></p> Participants<p></p> Men aged 60 to 79 without prevalent heart failure followed up for an average of 11.5 years (N = 3,925).<p></p> Measurements<p></p> All-cause mortality (n = 1,286) and self-reported mobility disability obtained at examination in 1998 to 2000 and in a postal questionnaire 3 to 5 years later in 2003.<p></p> Results<p></p> High D-dimer (top vs lowest tertile: adjusted odds ratio (aOR) = 1.46, 95% confidence interval = 1.02–2.05) and IL-6 (aOR = 1.43, 95% CI = 1.01–2.02) levels (but not CRP or fibrinogen) were associated with greater incident mobility limitation after adjustment for confounders and prevalent disease status. IL-6, CRP, fibrinogen, and D-dimer were significantly associated with total mortality after adjustment for confounders. Only D-dimer and IL-6 predicted total mortality independent of each other and the other biomarkers. The adjusted hazard ratio (aHR) was 1.16 (95% CI = 1.10–1.22) for a standard deviation increase in log D-dimer and 1.10 (95% CI = 1.04–1.18) for a standard deviation increase in log IL-6. D-dimer was independently related to vascular and nonvascular mortality, and IL-6 was independently related to vascular mortality. Risks of mobility limitation and mortality were greatest in those with a combination of high D-dimer and IL-6 levels.<p></p> Conclusion<p></p> D-dimer and IL-6 are associated with risk of mobility limitation and mortality in older men without heart failure. The findings suggest that coagulation leads to functional decline and mortality s that inflammation does not explain.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lowe, Professor Gordon
• Authors: Wannamethee, S. G., Whincup, P. H., Lennon, L., Papacosta, O., and Lowe, G. D.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of the American Geriatrics Society
• Publisher: Wiley
• ISSN: 0002-8614
• ISSN (Online): 1532-5415
• Copyright Holders: Copyright © 2014 The Authors
• First Published: First published in Journal of the American Geriatrics Society 62(12):2357-2362
• Publisher Policy: Reproduced under a Creative Commons License

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